ASGE/JGES Advanced ESD (On-demand)| July 2023-7-15-23 Bring Your Case 2

Video Transcription

Video Summary

Mayu Tanabe from Showa University Koto Teosho Hospital presents a case of chronic ESD with an SMD invasion in the sigmoid colon. Due to the patient's old age and comorbidities, ESD was chosen over surgery. Muscle layer retraction signs made it difficult to identify the incision line, but submucosal layers were identified on both sides of the retraction, helping to determine the correct incision line. Unexpected bleeding occurred, which was eventually controlled using a coragrasper. A small perforation was found from a penetrating artery, which was closed with clips. Incomplete resection of the lesion was achieved, but the patient did not experience postoperative issues. The final diagnosis confirmed the lesion as PT1B with negative margins and no lymphovascular invasion.

Keywords

chronic ESD

SMD invasion

sigmoid colon

muscle layer retraction signs

submucosal layers